Oct 02, 2018

10 years after the Commission on Social Determinants of Health: social injustice is still killing on a grand scale

The Lancet In 2008, WHO launched the final report of the Commission on Social Determinants of Health (CSDH) that concluded “social injustice is killing people on a grand scale”. A decade later, how should we judge the CSDH's impact? A Google search for the CSDH yields 156 000 results and the accompanying Lancet paper has had 932 citations. The CSDH led to two World Health Assembly resolutions and more than 100 countries adopted the Rio Political Declaration on Social Determinants of Health in 2011. The CSDH's report has become a foundational text for how crucial social determinants are to health and health equity. And yet, there has not been widespread policy uptake of its recommendations to improve daily living conditions, tackle the inequitable distribution of power, money, and resources, and monitor both inequities and the impact of policies to address them. Instead, although a number of countries actively engaged with the CSDH's ideas and gave policy consideration to social determinants, a revival of austerity policies harmed health and health equity, with stagnating life expectancy and widening mortality gaps in some countries. (Photo: s1ingshot/flickr, CC BY 2.0)